Atrial fibrillation/atrial flutter related mortality trends in the US population 2010-2020: Regional, racial, sex variations

Unraveling disparities: Probing gender, race, and geographic inequities in pulmonary heart disease mortality in the United States: An extensive longitudinal examination (1999-2020) leveraging CDC WONDER data

This comprehensive study delves into the epidemiological landscape of Pulmonary Heart Disease (PHD) mortality in the United States from 1999 to 2020, leveraging the extensive CDC WONDER database. PHD encompasses conditions affecting the right side of the heart due to lung disorders or elevated pressure in the pulmonary arteries, including pulmonary hypertension, pulmonary embolism, and chronic thromboembolic pulmonary hypertension (CTEPH). Analyzing data from death certificates, demographic characteristics, and geographical segmentation, significant trends emerge. The age-adjusted mortality rates (AAMRs) for PHD-related deaths show a fluctuating pattern, initially decreasing from 1999 to 2006, followed by a steady increase until 2020. Male patients consistently exhibit higher AAMRs than females, with notable disparities observed among racial/ethnic groups and geographic regions. Non-hispanic (NH) Black or African American individuals, residents of specific states like Colorado and the District of Columbia, and those in the Midwest region demonstrate elevated AAMRs. Furthermore, nonmetropolitan areas consistently manifest higher AAMRs than metropolitan areas. These findings underscore the urgent need for intensified prevention and treatment strategies to address the rising mortality associated with PHD, particularly among vulnerable populations. Insights from this study offer valuable guidance for public health initiatives aimed at reducing PHD-related mortality and improving outcomes nationwide.

Regional and Demographic Disparities in Atrial Fibrillation Mortality in the USA

BACKGROUND

Despite the burden of atrial fibrillation/flutter (AF/AFL) in the USA, an assessment of contemporary mortality trends is scarce in the literature. This study aimed to assess the temporal trends in AF/AFL deaths among US adults by age, sex, race/ethnicity, and census region from 1999 to 2020.

METHODS

National mortality data was abstracted from the National Center for Health Statistics to identify decedents whose underlying cause of death was cardiovascular disease and multiple cause of death, AF/AFL. Joinpoint regression assessed mortality trends, and we calculated the average percentage changes (APC) and average annual percentage changes in mortality rates. Results were presented as effect estimates and 95% confidence intervals (95% CI).

RESULTS

Between 1999 and 2020, 657,126 adults died from AF/AFL in the USA. Contemporary trends have worsened overall except among individuals from the Northeast region for whom the rates have remained stationary since 2015 (APC = 0.1; 95% CI, - 1.0, 1.1). Regional and demographic disparities were observed, with higher rates noted among younger persons below 65 years of age, women (APC = 2.1; 95% CI, 1.7, 2.5), and non-Hispanic Blacks (APC = 4.5; 95% CI, 3.9, 5.2).

CONCLUSIONS

The temporal trends in AF/AFL mortality in the USA have exhibited a worsening pattern in recent years, with regional and demographic disparities. Further investigations are warranted to explore the determinants of AF/AFL mortality in the US population and identify factors that may explain the observed differences. Understanding these factors will facilitate efforts to promote improved and equitable health outcomes for the population.